APTA Collaborates With Wal-Mart on PTA Coverage

At APTA's urging, Wal-Mart Corporation has changed its policy to cover services delivered by physical therapist assistants (PTAs). Effective July 1, Wal-Mart's medical plan, BlueAdvantage, will pay for services delivered by PTAs as long as they are under the direct supervision of a physical therapist (PT) and the claims are billed by the PT. These claims will be subject to the same coverage criteria as the plan’s physical therapy coverage criteria.

Wal-Mart's previous coverage policy stated, "Therapy is covered when prescribed by a physician and provided by a licensed physical therapist or occupational therapist."

Comments

Yeah? And I bet it's at "100% of the maximum benefit allowed" as well? LOL
When you look up the "maximum benefit allowed" it's 20 bucks.
No idea where it's all going to end. I wish I were more optimistic about this "Affordable Care Act" that nobody is going to be able to afford. Especially the people paying for it, and the providers.

Posted by Leon Richard
on 7/20/2012 3:07 PM

In a very conflicted way I am grateful as a PTA that Walmart has partially restored what should have never been denied to begin with. This seems akin to thanking them for allowing me to make a living in a job I've earned the right to perform for the past thirty years.
I think it is remarkable that these policies have been approved and implemented without the compelling evidence that I am not sufficiently capable or competent to perform my duties as a PTA. This form of oppression creates undue friction and is potentially very divisive. It does nothing to enhance the efficacy or efficiency of patient care outcomes financially or otherwise. It does however restrict and prejudicially inhibit the liberty, equitable trade and rights of commerce for the PTA's effected by such unreasonable decisions.

Posted by William B. Hunter
on 7/20/2012 3:32 PM

Way to go APTA! Thank you for your diligence and hard work on this.

Posted by Christie
on 7/20/2012 5:16 PM

Way to go APTA. I have many patients I get better and with all our communication with the PT we shouldn't be discrimated against. Many times I have patients request me vs my PT for therapy.

Posted by Brenda
on 7/20/2012 7:33 PM

Thank you APTA for your hard work and continued committment to PTAs! You are much appreciated!

Posted by Connie Smith
on 7/20/2012 8:05 PM

It's a start! Thank you, APTA

Posted by Lorraine Anthony -> =FW[=I
on 7/21/2012 1:12 PM

I think any such improvement is beneficial. I know many good PTA's and PT's it should be about patients not ego's.

Posted by chris poore
on 7/21/2012 4:49 PM

So now I guess we need laws to require state laws be followed - as such, if PT is a covered benefit - it's covered under the guidelines regulated by the state not each insurance provider. It's enough to have to educate politicians,without having to educate each insurance provider. Good start APTA but don't stop there, it's still unnecessary restrictions being placed upon the PTA which in-turn restricts their employment.

Posted by Jerry Yarborough SPT, PTA
on 7/21/2012 9:21 PM

This type of discrimination will not stop until PT/rehab companies stop accepting contracts that allow corporations and insurance carriers to dictate who is competent to treat patients. I can proudly say my company does not accept contracts that dictate who is allowed to treat the patients. Why would we allow Walmart or anyone else to tell us that PTA's are not good enough to see their employees?

Posted by Robert Wallace, PT, DPT
on 7/22/2012 3:11 AM

My apologies for not making clear my appreciation to the APTA for their advocacy and work on repealing this type of restriction. I was remiss by not making this point in an earlier comment, and I truly appreciate their involvement for doing so. This speaks to why membership is such an imperative for our profession.Thank you APTA!

Posted by Bill Hunter
on 7/23/2012 1:04 PM

Can somebody please clarify.. our PTA's have indirect supervision licenses. What does " will pay for services delivered by PTAs as long as they are under the direct supervision of a physical therapist (PT)" mean?? Thank you.

Posted by Cheryl Fromuth -> @IP^@N
on 7/23/2012 8:16 PM

As I have an exam on posture, balance, and sensory, I will keep my comments short. Before I began PT school I worked as a tech in an acute care and rehab setting for almost three years. The PT's were wonderful and consistently worked with the PTA's in a collaborative, non-threatening manner. It has been made clear to me over and over that it is the PTA's who feel threatened. Comments such as "PTA's are being discriminated against" and "My patients prefer me, a PTA, over a PT". I am both offended appalled. PT is my "second career". I have a BS in business and dance, with marketing/PR work experience for a few years following graduation. I made incredible sacrifices to become a physical therapist. I moved in with my parents to save money, took two prerequisite courses each semester for two years, and worked as a tech to gain experience. I have worked EXTREMELY hard to get into a top 20 DPT program. To be quite honest, I'm sick and tired of feeling like I can't fully perform my role as a DPT in the near future, because it might offend a PTA. Anyone can become a DPT. The question is, are you willing to put forth the effort and make sacrifices to realize it. Bottom line - the Doctor of Physical Therapy is just that - the person in charge. The role of the PT and PTA are very different. If they were not, the two would not exist. So, rather than find ways to complain about DPT's, try learning from their extensive education and in return they will do the same. I assure you, I will not know many things when I begin practicing and I plan to use my resources around me (PT's and PTA's alike!), but I expect to be treated with respect as someone who worked incredibly hard to become a Doctor of PT.